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Impact of cytogenetics on outcome of stem cell transplantation for acute myeloid leukemia in first remission: a large-scale retrospective analysis of data from the Japan Society for Hematopoietic Cell Transplantation.

AbstractOn the basis of transplantation data from the Japan Society for Hematopoietic Cell Transplantation, we retrospectively analyzed the impact of cytogenetics at diagnosis on the outcome of transplantation in 628 patients with acute myeloid leukemia who underwent autologous (n = 200), allogeneic related (n = 363), or allogenic unrelated (n = 65) stem cell transplantation (SCT) at first complete remission. For autologous SCT, patients at good cytogenetic risk had a significantly lower relapse rate (P = .017) and a significantly higher event-free survival (EFS) (P = .013) compared with those at intermediate risk. For allogeneic SCT, patients at good cytogenetic risk had a significantly lower relapse rate (P = .019) and insignificantly higher EFS (P = .093) than those at poor risk. For unrelated SCT, there was no significant difference in relapse rate or EFS between patients at good risk and those at intermediate risk. Comparison of the 3 transplantation modalities revealed that autologous SCT patients had a significantly higher incidence of relapse compared with related or unrelated SCT patients in the intermediate-risk group but not in the good-risk group. However, there were no significant differences in EFS among the 3 transplant modalities in either of these 2 risk groups. In multivariate analysis, cytogenetics was found to be an independent predictor of relapse as well as of treatment failure.
AuthorsHiroyasu Ogawa, Kazuhiro Ikegame, Manabu Kawakami, Satoshi Takahashi, Hisashi Sakamaki, Takahiro Karasuno, Hiroshi Sao, Yoshihisa Kodera, Noriyuki Hirabayashi, Shinichiro Okamoto, Mine Harada, Koji Iwato, Atsuo Maruta, Mitsune Tanimoto, Keisei Kawa, Japan Society for Hematopoietic Cell Transplantation (Affiliation: Department of Molecular Medicine, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan. ogawah at imed3.med.osaka-u.ac.jp)
JournalInternational journal of hematology (Int J Hematol) Vol. 79 Issue 5 Pg. 495-500 (Jun 2004) ISSN: 0925-5710 United States
PMID15239403 (Publication Type: Journal Article, Multicenter Study)
Topics
  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Child
  • Chromosome Aberrations
  • Cytogenetics
  • Disease-Free Survival
  • Female
  • Humans
  • Japan
  • Leukemia, Myeloid (genetics, therapy)
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation
  • Recurrence
  • Retrospective Studies
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome